Substance Use Disorder
(Drug Abuse; Drug Addiction; Drug Dependence)
A substance use disorder is when a person keeps using a substance despite physical, emotional, or social problems. The substance can be illegal drugs like cocaine, ecstasy, GHB, or heroin, marijuana, or prescription medicine. People may also misuse chemicals like inhalants.
The cause is not known. Things like genetics, the environment, and peer pressure may play a role.
Drugs stimulate unnecessary chemical release in the brain. Long-term drug use may change brain function.
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Things that may raise the risk of this problem are:
- Having other people in the family with substance use problems
- Having mental health problems, such as post-traumatic stress disorder, anxiety, depression, bipolar disorder, or panic disorder
- Social and peer pressure to use substances
- Early antisocial behavior, such as breaking the law or repeated lying
- Easy access to substances
- Lack of parent involvement
Problems may be:
- Poor control of the substance, such as:
- Taking it in much higher amounts for a longer time
- Problems trying to cut down or stop using it
- Spending large amounts of time getting or using it or recovering from using it
- Craving it
- Repeated work, school, home, or relationship problems due to substance use
- Using the substance even though it means risking physical safety or knowing it will make existing physical or mental problems worse
- Repeated trouble with the law, such as driving while under the influence of a substance or stealing to get the substance
The doctor will ask about symptoms and past health. They will also ask about history of substance use. An exam will be done.
Blood and urine tests may be done to check for substances.
There is no cure. The goals are to help someone to stop using the substance. Early steps also include helping to clear drug from the body to ease withdrawal.
It can take a long time to recover. Many people may need to be treated several times. It may include 1 or more of the following:
To lower the risk of this problem:
Drugs can create a physical dependency. This means there can be some difficult changes to the body once the drug is stopped. Treatment can help to ease some of these symptoms and provide care for severe reactions. It is often done in a care clinic with medical professionals.
- Drugs, brains, and behavior: The science of addiction. National Institute on Drug Abuse website. Available at: https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drug-abuse-addiction.
- Kampman K, Jarvis M. American Society of Addiction Medicine (ASAM) National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use. J Addict Med. 2015 Sep-Oct;9(5):358-367.
- Opioid abuse and dependence. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/opioid-abuse-and-dependence.
- Treatment approaches for drug addiction. National Institute on Drug Abuse website. Available at: https://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction.
- Adrian Preda, MD
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